24A-091 (3) BP-2023-1619
18 DICKINSON ST COMMONWEALTH OF MASSACHUSETTS
Map:Block:Lot:
24A-091-001 CITY OF NORTHAMPTON
Permit: Alts Renovations
Repair
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL c.142A)
BUILDING PERMIT
Permit# BP-2023-1619 PERMISSION IS HEREBY GRANTED TO:
Project# INTERIOR RENO 2023 Contractor: License:
Est. Cost: 200000 SCOTT NICKERSON 053156
Const.Class: Exp.Date: 01/10/2024
Use Group: Owner: LEE FRYDMAN SOFIA A&AMY J
Lot Size (sq.ft.)
Zoning: URA Applicant: SCOTT NICKERSON
Applicant Address Phone: Insurance:
PO BOX M (413)896-3347 0
LAKE PLEASANT, MA 01347
ISSUED ON: 12/05/2023
TO PERFORM THE FOLLOWING WORK:
INTERIOR RENO
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector
Underground: Service: Meter: Footings:
Rough: Rough: House # Foundation:
Final: Final: Final: Rough Frame:
Gas: Fire Department Driveway Final: Fireplace/Chimney:
Rough: Oil: Insulation:
Smoke: Final:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Signature: ( 9
51-1
Fees Paid: $1,300.00
212 Main Street,Phone(413)587-1240,Fax: (413)587-1272
Office of the Building Commissioner
-'let-WO I..)- 1 .4cTo _%. c
yy '4RE EfVL7.._a)
The Commonwealth of Massachuse NOV 1 5 20 OR
tt!, Board of Building Regulations and Stan ds
Massachusetts State Building Code, 780 M MUN IP ITY
_ SE
Building Permit Application To Construct,Repair, Re vatak tfliiitivhramsP 1f gMa 2011
THAMPTON.MA 01060
One-or Two-Family Dwelling
This Section For Official Use Only
Building Permit Number: cal "3•/Of 1 Date Applpiedd:
I i; ,2
� a,: . ii ,, , Asc
Building Official(Print Name) Signature It/
SECTION 1: SITE INFORMATION
1.1 Property dr� 1.2 Assessors Map&Parcel Numbers
/ street? MapNumber Parcel Number
l.la Is this an accepted yes no
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area(sq ft) Frontage(ft)
1.5 Building Setbacks(ft)
Front Yard Side Yards • Rear Yard
Require Provided Required Provided Required Provided
1.6 Wate ply:(M.G.L c.40,§54) 1.7 FIoo Ane Information: 1.8 Sewa u I I osal System:
Publi Private❑ Zone: _ Outside Flood Zone? Munici• ■
Check if yes❑ On site disposal system CI
SECTION 2: PROPERTY OWNERSHIP'
2.1 Owner'of Record:
cktnVitDSeS 444. if-tet We,na Woo iloken) NIP.OtO(oO
ame( t) City,State,ZIP
fS flir-k►vtso+1a. yljD 1O$333-1- ,e.�a.J. 2oZ1@�ati,,&a►1.coon
No.and Street Telephone � Em it Address C�J
SECTION 3:DESCRIPT OF PROPOS 2(check all that apply)
New Construction 0 Existing Building Owner-Occupi Repairs(s) la Alteration(s) Id/ Addition 0
Demolition 0 Accessory Bldg. 0 Number of Units / Other 0 Specify:
Brief Description of Proposed Wor :
_.1.707 7€44—_, 74.44,./.7-4-- U ra 01-07- re.75
SECTION 4:ESTIMATED CONSTRUCTION COSTS
Item Estimated Costs: Official Use Only
(Labor and Materials)
1. Building sii, ao d 1. Building Permit Fee: $ Indicate how fee is determined:
2.Electrical $ f 0 Standard City/Town Application Fee
1S/ o 0 Total Project Costa(Item 6)x multiplier x
3.Plumbing $ go D o a 2. Other Fees: $
4.Mechanical (HVAC) $ �- List:
5.Mechanical (Fire $ ,,,,,,
Suppression) Total All Fees: $1 Check No. 113 i Check AA:`)
6.Total Project Cost: $ p•0 Qr'd i 0 Paid in Full 0 Outstanding Balance Due:
•
City of Northampton
`::" Massachusetts �; ''
��"
s
i ° a
:, DEPARTMENT OF BUILDING INSPECTIONS t
212 Main Street • Municipal Building 1.
212
, ' Northampton, MA 01060
PROCEDURE FOR-OBTAINING A BUILDING PERMIT FOR WINDOWS,
DOORS,ROOFS,RENOVATIONS,ROOF MOUNTED SOLAR,ETC.
1. Building Permit Application signed by legal owner and filled out
by owner.or authorized agent.
2. One set of plans and specifications of proposed work(Digital and hard copy).
3. Construction Debris Affidavit filled out and signed by applicant.
4. Worker's Compensation Insurance Affidavit filled out and signed by applicant.
5. Contractors must supply a copy CSL, HIC, and proof of Liability Insurance.
6. Energy Conservation Compliance Certificate (new/replacement windows).
7. Home owner's License Exemption Form (if applicable).
8. Note any Special Permit requirements(if applicable).
9. Energy Code—all new construction (Gut/Rehab) requires a HERS Rater Affidavit
10. Please provide the appropriate fee in the,form of a check made payable to: The City of
Northampton.
SECTION 5: CONSTRUCTION SERVICES
5.1 Construction Supervisor7 Licensece (CSL) S3/f, / /G zY
jo ,y /�c cier.f c'1 License Number Expir Lion Date
Name of CSL Holder
Z1,. List CSL Type(see below)
No.and Street 4 Type Description
/ L Ce t'R iL/ 6/3 Unrestricted(Buildings up to 35,000 Cu. 11 )
A .t ( t/ Restricted 1&2 Family Dwelling
City/Town,State,ZIP I M Masonry
RC Roofmg Covering
WS Window and Siding
e u SF Solid Fuel Burning Appliances
y/3 -D 7‘ ^33 " IdKt s _i ¶ I Insulation
Telephone Email address D Demolition
5.2 Registered Home Improvement Contractor(HIC) /f 13 > 1— 7//?/J 3'
sq h.►� Gc.i 46..P HIC Registration Number $xpir tion Date
HIC Company Name or HIC Registrant Name
No.and Street Email address
City/Town,State,ZIP Telephone
SECTION 6:WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c. 152.§ 25C(6))
Workers Compensation Insurance affidavit must be co pleted and submitted with this application. Failure to provide
this affidavit will result in the denial of the Issuanc f the building permit.
Signed Affidavit Attached? Yes No 0
SECTION 7a:OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNER'S AGENT OR CONTRACTOR
AAPPLIES FOR
/BUILDING PERMIT
I,as Owner of the subject property,hereby authorize.CE e'./ v1
to act on my behalf,in all matters relative to work authorized by this building permit application.
‘11112-e z3
Print Owner's Name(Electronic Signatu Date
SECTION 7b: OWNER'OR AUTHORIZ AGENT DECLARATION
By entering my name below,I hereby attest under the pai d penalties of e hat all of the information
contained in this application is true and accurate to st of edge and understanding.
Si7� - i �,.f� // " .0
Print Owner's or Authorized Agent's Name(Electronic Signature) Date
NOTES:
1. An Owner who obtains a building permit to do his/her own work,or an owner who hires an unregistered contractor
(not registered in the Home Improvement Contractor(HIC)Program),will not have access to the arbitration
program or guaranty fund under M.G.L.c. 142A. Other important information on the HIC Program can be found at
www.mass.gov/oca Information on the Construction Supervisor License can be found at www.mass.gov/dps
2. When substantial work is planned,provide the information below:
Total floor area(sq.ft.) (including garage,finished basement/attics,decks or porch)
Gross living area(sq.ft.) Habitable room count
Number of fireplaces Number of bedrooms
Number of bathrooms Number of half/baths
Type of heating system Number of decks/porches
Type of cooling system Enclosed Open
3. "Total Project Square Footage"may be substituted for"Total Project Cost"
4
The Commonwealth of Alassachusets
=I.Tittr-e
Department of Industrial Accidents
I Congress Street,Suite 100
Boston, MA 02114-2017
-Jam
ww)entass.govidia
VI,takers Compensation Insurance Affida N it:BuilderaVontractorrifElectricia us/Pluto hers.
ft)BE f TILED XS I I'D Illk.1,EICS/111ING A(714014111.
Antillean t I oforniation Please Print 1.ettibls
Name 411umheaodOrganizotioni1naireidualr.... .-.075 X-461-e#-1.42 IA
•
Address: /4) -.234'X /411
CityStateiZip: Z4 ,4,Liu--7.11til 0/3/500ne#: Y/3 — V U
Are yaw an employ eel Cheek the II pprvipriatv bad r Type of project(required):
I.0 I 4111 a oyer wiaa ,,,, employeeh fftill minim parts-iiine].* 7. Ei New contrition
2. ern a sole gnsprichar or parlinerthip and have no triployeen working ter me in 8 0 Remodebrig
any capacity,rhio workers'comp.lams-mutt required]
9.. El 13cmolition
31D I am a&noon wrier doing all work myself fNei woricant com urance required.]'
10 Ei Building addition
4,0 1 41113.Intrnw*Aencr and nil]be hiring dantradors to conduct all work on my preptaty. 1 will
minima that all contractors Vithi.,V lave Woken'conspemalion ireammee oi me.k. I 1.E3 Electrical repairs or additions
prop-edema with no eiripkiyan,
1 2,1:3 Plunibing repairs or additionN
50 I am a general contractor and I ita‘e lined the Nt11/-tatittltett.11,11.441,1 f313 the anadied shed
i 30 Roof repairs,
These siabaninuactera have employees aid haat workers'coop.insurance)
14.0 Othei-
a0 We aie a in and its officers haat,eirdied their right or exempla=pm Mett.et.
I.*-2.,§114h and We Itavc no croployeesi.No worked'clump..iromance requitetti
*Any applicant that sleeks bna al itaan oho fill ma nit metioat below!Moo ing their workers'couipensation potiey infornantiort
t linincenners aho submit dos affiska vit.indwating they am eking all work and then hire ereside crinienetedi must saihinit a new affidavit indicaung NUC11
ICurittaciers Mat_check thin bee&Ago atticluai an Additional shed show in the naane of the mih-eoritra,cloti.and'gate >alleltlix or oat&Ott entitir-, it ,
,mpioVtA.,.., if the N146-1.;t1142'41.101S 11.31/4,!,;Inpiolf...Vi,the niuNt prn%.ide their workers'comp.policy nisiohd
— t
I am tin employer that Ls providing workers°elimpensation insurance for my employees. Below is the policy and Job.sire
information.
Insurance Company Name. ___
. Policy#or Self-ins. Lk.#: Expiration Date:
Joh Site Address: City'Stine:Zip:
Attach a copy of the worken'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under NIGL c.. 152,§25A is a criminal violation punishable by a fine up to SI.S0C).00
artil'or one-year imprisonment.as well as civil pienalticis in the fmrri of a STOP WORK ORDER and a(me of up to S250.00 a
day against the violator.A cop is statement may be forwarded to the Office of Investigations of the DIA for insurance
coverage verification.. -
.
I do Iterehy certify un ' .,. ' that the information provided boy is true and correer.
Sivature: Dale // ii --7
Phone#: .y/ 3 - 3 .;Y ?..
" Official use only. Do run write in this area,to he completed by ci(r or town official.
I City or Town: Permit/License#
i Issuing Authority (circle one :
I.Board of Health 2.Building Department 3.Cityrfown Clerk 4.Electrical Inspector 5. Plumbing Inspector
6.Other
l'untact Person: Phone#i
4-
City of Northampton
Massachusetts
*
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DEPARTMENT OF BUILDING INSPECTIONS
212 Main Street • Municipal Building
Northampton, MA 01060 � r11,'•
CONSTRUCTION DEBRIS AFFIDAVIT
(FOR ALL DEMOLITION AND RENOVATION PROJECTS)
In accordance of the provisions of MGL c 40, S54, a condition of Building Permit
Number is that all debris resulting from this work shall be disposed of
in a properly licensed waste disposal facility, as defined by MGL c 111, S 150A.
The debris will be disposed of in:
Location of Facility: �` 1// gee cJ( L— 71.4
i �A1 _
J
The debris will be transported by:
Name of Hauler: . A Ie� 1 c—+-•
Signature of Applica : Date: 151//,.43
City of Northampton
% Massachusetts rr
x.4%4 DEPARTMENT OF BUILDING INSPECTIONS '
212 Main Street • Municipal Building
t�
Northampton, MA 01060
HOMEOWNERS'EXEMPTION ELIGIBILITY AFFIDAVIT
I, (insert full legal name), born_(insert
month, day,year), hereby depose and state the following:
. 1. I am seeking a building permit pursuant to the homeowners'exemption to the permit requirements of the
Massachusetts State Building Code, codified at 780 CMR 110.R5.1.3.1, in connection with a project or
work on a parcel of land to which I hold legal title.
2. I am not engaged in, and the project or work for which I am seeking the aforementioned homeowners'
exemption, does not involve the field erection of manufactured buildings constructed in accordance with
780 CMR 110.R3.
3. I qualify under the State Building Code's definition of"homeowner"as defined at 780 CMR 110.R5.1.2:
Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which
there is, or is intended to be, a one-or two-family dwelling, attached or detached structures
accessory to such use and/or farm structures. A person who constructs more than one home in
a two-year period shall not be considered a home owner.
4. I do not hold a valid Massachusetts construction supervision license and, except to the extent that I
qualify for and will abide by the Massachusetts State Building Code's requirements for the supervision of
the project or work on my parcel, I am not engaged in construction supervision in connection with any
project or work involving construction, reconstruction, alteration, repair, removal or demolition
involving any activity regulated by any provision of the Massachusetts State Building Code.
5. If I engage any other person or persons for hire in connection with the aforementioned project or work on
my parcel,I acknowledge that I am required to and will act as the supervisor for said project or work.
Signed under the pains and penalties of perjury on this day of , 20_.
(Signature)
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21hIJK I LW L I. MEMBER REPORT PASSED
2ND FLR FRMNG,Wall: Header
2 piece(s) 1 3/4' x 11 7/8' 2.0E Microllam® LVL
Overall Length:9'
+ ,.
0 0
(, 86 4
El El
All locations are measured from the outside face of left support(or left cantilever end).All dimensions are horizontal.
Design Results Actual 0 Location Allowed Result LDF Load:Combination(Pattern) System:Wall
Member Reaction (Ibs) 5806 C 1 1/2' 7613(3.00') Passed (76%) -- 1.0 D +1.0 L(All Spans) Member Type:Header
Shear(Ibs) 4206 C 1'2 7/8' 7897 Passed (53%) 1.00 1.0 D +1.0 L(All Spans) Budding Use:Residential
Budding Code:IBC 2015
Moment(Ft-lbs) 12347 C 4'6' 17848 Passed (69%) 1.00 1.0 D +1.0 L(All Spans) Design Methodology:ASD
Live Load Defl.(in) 0.141 6 4'6' 0.292 Passed(U745) -- 1.0 D +1.0 L(All Spans)
Total Load Defl.(in) 0.208 0 4'6' 0.438 Passed(L/504) -- 1.0 D+1.0 L(All Spans)
• Deflection criteria:LL(U360)and TL(U240).
•Mowed moment does not reflect the adjustment for the beam stabidty factor.
Bearing Length Loads to Supports(Ibs)
Supports Total Available Required Dead Floor Live Snow Factored Accessories
1-Trimmer-SPF 3.00' 3.00' 2.29' 1877 3929 932 5806 None
2-Trimmer-SPF 3.00' 3.00' 2.29' 1877 3929 932 5806 None
Lateral Bracing Bracing Intervals Comments
Top Edge(Lu) 9'o/c
Bottom Edge(Lu) 9'o/c
•Maximum allowable bracing intervals based on applied load.
Dead Floor Live Snow
Vertical Loads Location Tributary Width (0.90) (1.00) (1.15) Comments
0-Self Weight(PLF) 0 to 9' N/A 12.1 -- --
1-Uniform(PLF) 0 to 9' N/A 231.0 433.0 207.0
2-Uniform(PSF) 0 to 9' 11' 10.0 40.0 -
3-Uniform(PLF) 0 to 9' N/A 64-0 - -
Weyerhaeuser Notes
Weyerhaeuser warrants that the sizing of its products will be in accordance with Weyerhaeuser product design criteria and published design values.Weyerhaeuser expressly disclaims any other warranties
related to the software.Use of this software is not intended to circumvent the need for a design professional as determined by the authority having jurisdiction.The designer of record,budder or framer is
responsible to assure that this calculation in compatible with the overall project.Accessories(Rim Board,Blocking Panels and Squash Blocks)are not designed by this software.Products manufactured at
Weyerhaeuser facilities are third-party certified to sustainable forestry standards.Weyerhaeuser Engineered Lumber Products have been evaluated by ICC-ES under evaluation reports ESR-1153 and ESR-1387
and/or tested in accordance with applicable ASTM standards.For current code evaluation reports,Weyerhaeuser product literature and installation details refer to
www.weyerhaeuser.com/woodproducts/document-library.
The product application,input design loads,dimensions and support information have been provided by ForteWEB Software Operator
ForteWEB Software Operator Job Notes 11/9/2023 5:00:24 PM UTC
Peter Van Buren
COWLS BUILDING SUPPLY ForteWEB v3.6, Engine:V8.3.1.5, Data:V8.1.4.1
pets cowls.01 Flle Name: 18 DICKENSON ST. NORTHAMPTON, MA
pets®cowls.com Wcyerhacuur
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